Infarct location predicts progressive motor deficits in patients with infarct in the perforator territory of the middle cerebral artery / 国际脑血管病杂志

ABSTRACT

Objective To investigate the relationship between the pattern of infarct distribution on diffusion-weight imaging (DWI) and progressive movement deficits (PMD) in patients with infarct in the perforator territory of the middle cerebral artery (MCA). Methods The patients with new infarction in the perforator territory of MCA were analyzed retrospectively. PMD was defined as an increase of at least 2 points on the motor item of the National Institutes of Health Stroke Scale (NIHSS) score persisting for at least 24 hours within 5 days of stroke onset. The demographic characteristics, risk factors, clinical presentation, and distribution characteristics of the infarcts in the PMD and non-PMD groups were compared. Results A total of 64 patients were enrol ed in the study, including 38 females and 26 males, aged 67. 5 ± 10. 8 years. There were 28 patients in the PMD group and 36 in the non-PMD group. The proportion of the infarcts located in the posterior paraventricular region (67. 8% vs. 25. 0%; χ2 =11. 5, P<0. 05) of the PMD group and the mean baseline NIHSS score (6. 9 ± 1. 8 vs. 4. 3 ± 1. 2; t=2. 42, P<0. 05) were significantly higher than those of the non-PMD group. Multiple logistic regression analysis showed that the posterior paraventricular type infarcts had significantly independently correlation with PMD (odds ratio 6. 31, 95% confidence interval 2. 20-18. 0; P<0. 001). Conclusions The posterior paraventricular type infarcts on DWI can be used as a neuroimaging marker for predicting PMD in patients with infarction in the perforator artery territory of MCA.